Provider Demographics
NPI:1427377076
Name:NOVIS, SARAH JANE (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:NOVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-366-3040
Mailing Address - Fax:843-366-3041
Practice Address - Street 1:3980 HIGHWAY 9 E STE 340
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-8165
Practice Address - Country:US
Practice Address - Phone:843-366-3040
Practice Address - Fax:843-366-3041
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME122245207YS0123X, 207Y00000X
SC40765207Y00000X
TXQ7938207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL150NAOtherBLUE CROSS BLUE SHIELD
FL014937100Medicaid
SC407651Medicaid
FL014937100Medicaid